| NPI | 1750805354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY BENNARDO Owner 847-888-8311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019022187) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2017-07-26 |